Fever and Ague on the Frontier

Fever and Ague was a common malady on the American frontier.

I am sitting down to write this article roughly 15 months after the initial US lockdowns related to Covid-19. While the virus has plenty of controversy surrounding it, there are a few things that everyone would agree on. One, we know that sickness is caused by a virus. Two, we know how it spreads. Three, hospitals seem to have a better understanding of how to treat it. While people may disagree on how frightening the virus actually is, it would be a heck of a lot more frightening if none of those three things was a reality.

In a way, that was how medicine in the past worked. In fact, it wasn’t until the late 19th century that scientists discovered that bacteria even caused diseases. Since then, medical advancement has been slowly and steadily creating a better and more reliable way of treating disease. One disease in the past that was particularly devastating was fever and ague.

I first learned about fever and ague while reading the Laura Ingalls Wilder book Little House on the Priaire to my daughters. In the book, Laura remembers everyone in the house getting sick, and ultimately passing out from fever. Eventually, she has a brief period of consciousness and recalled a black doctor coming to offer her medicine. Although the entire Ingalls family fell sick, all survived with the doctor’s help. After regaining their health, the family and community members debated what caused the disease in the first place. The idea that seemed to generate the most support was that it was caused by eating watermelons that had been planted along the creek. Laura’s father didn’t believe that was the case and deliberately ate as much watermelon as he could in order to prove the point. Ingalls tells the story like this:

“Ma would not taste it. She would not let Laura and Mary eat one bite. But Pa ate slice after slice after slice, until at last he sighed and said the cow could have the rest of it.

“Next day he had a little chill and a little fever. Ma blamed the watermelon. But next day she had a chill and a little fever. So, they did not know what could have caused their fever’n’ague.

“No one knew, in those days, that fever’n’ague was malaria, and that some mosquitoes give it to people when they bite them.”

If nothing else, this story sheds a little light on medicine on the frontier. It was unsophisticated at best, and people literally had no idea what caused diseases that could kill them.

If you are reading History of the West with Sam Payne: Pony Boy, you know that some of Sam’s friends come down with fever and ague. When Sam reaches the doctor, he is given a small bottle of quinine to treat it. Quinine was first used to treat the disease that we know as malaria in the 17th century. Quinine comes from the dried bark of the cinchona tree. On the frontier, it was ground into a powder and then drank by the person who was exhibiting symptoms. If the diagnosis was correct and in time, the drug would attack, kill, and prevent the malarial parasite in the infected body. Although medical personnel didn’t understand how it worked, by 1860, the doctor at Fort Laramie certainly would have known to use quinine as medicine against fever and ague.

Eventually, scientists discovered that watermelons, bad air, or “spores of microscopic bacteria floating in the air” didn’t cause the sickness and that it was actually transmitted by mosquitos. Fortunately, in the early 1950s malaria was declared to be eradicated from the United States. Unfortunately, malaria still kills hundreds of thousands of people every year around the world. These days, however, it is not a case of not knowing what malaria is, how to treat it, or how to stop it. Perhaps one day, this historically deadly disease will be eradicated from the earth.